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The “How To”
on Fraud Risk Assessment
Monica Frazer, CPA
Vice President, Internal Audit
Baylor Health Care System
Agenda
 Expectations for Fraud Risk Assessments
 Antifraud Programs and Controls
 Methodology
 Importance of Communication
 Benefits of a Fraud Risk Assessment
What is a Fraud Risk
Assessment?
An entity-wide examination of a company’s
vulnerability to potential fraud schemes.
Lesson #1
Companies are expected to perform fraud
risk assessments.
Why?
 Increased legislation, regulatory
requirements, and professional guidance.
 Renewed focus due to high-profile
scandals.
 Good business practice.
Sarbanes-Oxley Act
of 2002
302 (Quarterly Certifications)
Management discloses to the independent auditors
and Audit Committee any fraud that involves
management or other employees having a significant
role in the company’s internal controls.
404 (Annual Assertion)
Management’s assertion regarding effectiveness of
internal controls over financial reporting (ICFR) –
defined by SEC to include controls related to
“prevention, detection and identification of fraud.”
Sarbanes-Oxley Act
of 2002
The Sarbanes-Oxley Act requires that each
company have a documented and on-going
process to identify, assess, and evaluate fraud
risks related to internal control over financial
reporting.
Public Company Accounting
Oversight Board (PCAOB)
 Emphasizes importance of antifraud
controls.
 Requires independent auditors to evaluate
the fraud-related activities of the internal
audit department annually.
United States Sentencing
Guidelines
 8B2.1 (Effective Compliance and Ethics Program):
Accepted universally as the benchmark of an effective
program.
 DOJ and SEC use for charging and sanctioning
decisions.
 Requires periodically assessing the risk that unlawful
conduct will occur.
 2004 amendments create substantial overlap
between USSG and Sarbanes-Oxley requirements for
antifraud programs.
June 2007 SEC
Guidelines to Management
Explicitly requires management to conduct a
fraud risk assessment of corruption,
fraudulent financial reporting, and asset
misappropriation.
IIA Standard 1210:
Proficiency
1210.A2 – Internal auditors must have
sufficient knowledge to evaluate the risk of
fraud and the manner in which it is managed
by the organization, but are not expected to
have the expertise of a person whose
primary responsibility is detecting and
investigating fraud.
IIA Practice Advisory 1210 A2-1
(Fraud Risk Assessment,
Prevention & Detection)
 Perform or evaluate management’s fraud
risk assessment.
 Consider fraud risk in developing the
annual audit plan.
 Be alert to circumstances giving rise to
fraud.
IIA Practice Advisory 1210 A2-2
(Investigation Reporting,
Resolution, Communication)
 Assist management pursue discipline and
prevent occurrence.
 Help design external and internal
communication.
 Form an opinion on internal control related
to fraud.
IIA Standard 1220: Due
Professional Care
1220.A1 – Internal auditors must exercise
due professional care by considering
the…Probability of significant errors, fraud,
or noncompliance.
IIA Standard 2060: Reporting to
Senior Management and the Board
Reporting must also include significant risk
exposures and control issues, including
fraud risks, governance issues, and other
matters needed or requested by senior
management and the board.
IIA Standard 2010:
Risk Management
2120.A2 – The internal audit activity must
evaluate the potential for the occurrence of
fraud and how the organization manages
fraud risk.
IIA Standard 2210:
Engagement Objectives
2210.A2 – Internal auditors must consider
the probability of significant errors, fraud,
noncompliance, and other exposures when
developing the engagement objectives.
Lesson #2
Fraud risk assessments should be an
integral component of an organization’s
antifraud programs and controls.
Essential Elements
Tone at the Top
Code of Conduct
Monitoring Activities
Whistleblower Hotline
Fraud Risk Assessment
Fraud Training & Awareness
Hiring & Promotion Procedures
A fraud risk assessment is the cornerstone of
an antifraud program that anticipates, rather
than reacts to, fraud and misconduct.
PricewaterhouseCoopers
The Emerging Role of Internal Audit in Mitigating Fraud and Reputation Risks
Lesson #3
Develop a methodology.
Steps?
 Establish a framework
 Identify fraud risks
 Assess fraud risks
 Evaluate existing controls
 Develop a remediation plan
 Integrate with annual audit plan
As the central guide for the assessment process, the
framework provides a structure for assessing the fraud
risks and related controls.
 Fraud Risk Matrix (Excel spreadsheet)
 Primary document for collecting assessment data
 Captures:
- identified fraud risks
- assessment of risks
- mitigating controls
- remediation plans
Fraud Risk Matrix
Fraud Scenario
Company would conduct
business with a vendor owned
by an employee/friend or
family member of an employee
Company would make illegal
copies of software or install
software beyond what is
allowed by licensing agreement
Employee would assist vendor
in winning a bid for a project
Employee would install
software with the purposes of
controlling, damaging or
stealing data to allow
unauthorized access to the
network
Employees would steal patient
information for the purposes of
identity theft
Physician would not be paid in
accordance with an executed
contract
L
I
Results
(LxI)
Antifraud
Controls
Evaluation of Antifraud
Design
Effectiveness
Control
Gaps
Remediation
Steps
Fraud Risk Matrix
Fraud Scenario
Patients would be charged for
services not provided
Physician is occupying space
without paying rent
Employee would up-code in
order to increase revenue
Employee would intentionally
manipulate the books and
records to meet budget or
expectations
L
I
Results
(LxI)
Antifraud
Controls
Evaluation of Antifraud
Design
Effectiveness
Control
Gaps
Remediation
Steps
Through management interviews, historical trend
analysis, and external research, a fraud risk universe is
developed.
 Includes all possible fraud schemes that could
impact your company
 Schemes are classified according to the Uniform
Occupational Fraud Classification System
(Association of Certified Fraud Examiners)
 Interviews with management provide experienced
insight into actual and potential fraud schemes
An assessment is conducted for each risk scheme to ensure an
appropriate response.
 Each risk is evaluated in terms of likelihood and impact
 Likelihood assessment assigns a numeric ranking to the inherent
probability that the risk will occur, assuming no controls in place to
mitigate the risk
 Impact assessment assigns a numeric ranking to the impact the risk
would have on the organization if it occurred:
- Financial loss or misstatements within the financial statements.
- Consequences of fraud on the company’s reputation.
- Impact on operations
 Risks assigned to Fraud Risk Map
To prioritize mitigation efforts and effectively allocate
resources, each risk is assigned to a quadrant on the Fraud
Risk Map. The purpose of the Fraud Risk Map is to guide
the appropriate response for each potential fraud scheme.
Quadrant II
(Detect and
Monitor)
Impact of
Risks
Quadrant VI
(Low Control)
Quadrant I
(Prevent at
Source)
Quadrant III
(Monitor)
Likelihood of Risks
For each fraud risk, mitigating controls are identified and evaluated.
Controls are evaluated based on two criteria:
adequacy of design
Considers whether, if the identified controls operate as designed,
the fraud risk will be adequately mitigated.
effectiveness of operation
Considers whether a properly designed control is operating as
designed and whether the person performing the control has the
necessary authority, skill, and qualifications to perform the control
effectively. Evaluating operating effectiveness involves testing the
controls.
Plans are developed to remediate any residual
fraud risks.
 Residual risk = risk not adequately mitigated by
antifraud programs and controls
 Process owners are required to develop a
remediation plan
 Internal Audit will follow up and report on
management’s progress toward implementing
the plan
Risks identified through the fraud risk assessment are
factored into annual audit planning.
 Results are integrated with the annual risk assessment
 Annual risk assessment is performed to ensure that
significant financial, operational, and information systems
risks are appropriately addressed
 Audits are prioritized based on their relative level of risk,
which includes multiple risk factors in addition to fraud
risk
Lesson #4
Communication is paramount for a successful
fraud risk assessment.
The message:
 What is the definition of fraud?
 Why perform a fraud risk assessment?
 How will the information be used?
 Who will have access to the information?
 How does a fraud risk assessment differ from the annual
risk assessment?
 What level of resources will be required?
The approach:
 Start at the Top
 Communicate at All Levels
 Communicate Inside & Outside the Audit Department
 Communicate Often
 Listen Well
Lesson #5
The benefits of a fraud risk assessment are
numerous.
For the company:
 Safeguard brand value and reputation
 Increase earnings
 Meet IIA, SEC, SOX, and other standards and
requirements for antifraud programs and
controls
 Mitigate SEC and Department of Justice
sanctions
For Internal Audit:
 Another Value-Added Activity
 Leading Role in a High-Visibility Area
 Complements the Annual Risk Assessment
 Excellent Training for Staff
 Platform for Partnerships
Lesson #6
Yes, it really is that important...
The Take-Away
Facilitating a comprehensive fraud and
reputation risk assessment is the single-most
important contribution that Internal Audit
can contribute to an organization’s antifraud
programs and controls.
PricewaterhouseCoopers
The Emerging Role of Internal Audit in Mitigating Fraud and Reputation Risks
Thank You!
Monica Frazer
monica.frazer@baylorhealth.edu
214.820.8327
Save the Date:
August 26-29,
2012
31st Annual
Conference in
Philadelphia
Pennsylvania